Knee Replacement Failure - Need total reconstruction

Posted by babette @babette, Jul 27, 2019

I'm pretty devastated, everyone. I had my R TKR a year ago and always knew something wasn't right. My initial surgeon said everything looked great and to give it time, PT, etc. Well I went to one of the top ortho hospitals in the country yesterday and saw a surgeon who comes very highly recommended. He told me my femur is out of alignment, there is a problem with a ligament, and my knee cap is off to one side. I wish I had written down more specifics, dh was with me but once we heard this would all have to be redone, I think we went into kind of shock and didn't process the details very well. **He understood completely why I've been in so much pain this past year. ** He referred me to a colleague who does more complex revisions than he does and I feel great about that but have to wait a month to see him and begin the process. All over again. I have no idea what this will be like, the actual surgery, recovery, etc.

I'd love to hear from others who have gone through this. Also, has anyone successfully sued the surgeon who screwed up? I'm furious to have lost a year of my life to this and now even more time to the repair and recovery.

@johnbishop

JK @contentandwell, It seems like when it rains it pours. I am so sorry to hear about your fracture and pain. It would be inconvenient at any time but especially when it interferes with your son's wedding. Is there a possibility of wearing some sort of brace to prevent any further problems and hopefully reduce the pain some if you are able to travel with it?

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@johnbishop Thanks, John, but I’ve been to the ER doctor and two orthos and no one suggested that might help. We leave here on the 21st so hopefully by then there will be some improvement. I guess I’ll just take my strongest pain medication before the flight and pray for the best. They would have to put me in the hospital for me to miss his wedding.
JK

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@contentandwell

@jeffkirc Thanks, Jeff. I am working very hard at staying positive. I hardly slept last night due to pain so this morning I was pretty down and couldn't imagine myself doing the trek to CO but it is tolerable right now, thanks to some meds. I hope the doctor will re-prescribe, they are so overly cautious now.

@ellerbracke That is what I am concerned, the plane and then the activities out there — a family barbecue at my son's house on Thursday night, a big rehearsal dinner and reception on Friday night (that I have arranged and am paying for so I certainly want to be present), a women's brunch with hair being done at my son's home on Saturday morning and then the wedding on Saturday night. Our plans are to take a red-eye home on Tuesday night, we wanted to do some sightseeing but at this point, I think I may look into changing our flights. Even if we have a penalty it would be somewhat offset by not having the expense of a hotel room.
I think the extent of the injury probably has more to do with my bone density than anything else, although my husband says I went down really hard so it may just be that. I broke a vertebra when I was in my 50s and they immediately thought it must be due to my bones being weak but when they did a density scan they were great but I had not gone through menopause at that time. Another one I went down hard on, on concrete steps. This accident happened, ironically, due to extreme pain in my other leg from sciatica! The pain was so intense that I passed out or probably it was a presyncope episode. Now that leg doesn't hurt at all! I hate not exercising, I feel like my hard work is going down the tubes now. I feel like a slug.

@debbraw Thanks. The doctors have not said much about the pain. The strange thing is that when I went to the ER last Tuesday they kept asking me about my level of pain (1 to 10) and when I was lying on the bed it was negligible but last night it was very bad as it was this morning, even just lying in bed. I hope I haven't done anything to make things worse. They said with this type of fracture since it's not weight-bearing, that I could do whatever I am comfortable with. Right now I am not feeling very comfortable with that and I may try to get in to see the doctor again, or possibly go the Boston to see a different ortho. I would be handling this so much better if not for the timing. I don't dare tell my son that there is some possibility that I may not be able to go, and I don't even want to admit that to myself. I know if I don't go that my husband won't either and he's my son's best man!
JK

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Oh @contentandwell – I cannot imagine the stress you are going through. I think I would definitely see the doctor again – or a different ortho if you are more comfortable with that. I was a little surprised that they were actually going to let you fly with a fracture. I believe I'd want to really talk it over with the doctor. You've probably done that, but I know for sure that they don't won't you to fly for 6 – 12 weeks after a joint replacement. Sending you good wishes – fingers crossed.

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@debbraw

Oh @contentandwell – I cannot imagine the stress you are going through. I think I would definitely see the doctor again – or a different ortho if you are more comfortable with that. I was a little surprised that they were actually going to let you fly with a fracture. I believe I'd want to really talk it over with the doctor. You've probably done that, but I know for sure that they don't won't you to fly for 6 – 12 weeks after a joint replacement. Sending you good wishes – fingers crossed.

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@merpreb Since there is nothing they do for this type of fracture neither ortho suggested not flying. Maybe they just knew that I’m a determined mother and almost nothing would hold me back.

I am think about returning to the doctor but I don’t who to see. The doctor here in Manchester has excellent credentials but if surgery was necessary I do not want to go into that hospital again. I would be far more comfortable going to Boston but that could take a while to get an appointment, plus I don’t know who I would choose.

A friend brought dinner for us over tonight and there’s definitely enough for a couple of nights so that’s a big help.
JK

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@contentandwell

@jeffkirc Thanks, Jeff. I am working very hard at staying positive. I hardly slept last night due to pain so this morning I was pretty down and couldn't imagine myself doing the trek to CO but it is tolerable right now, thanks to some meds. I hope the doctor will re-prescribe, they are so overly cautious now.

@ellerbracke That is what I am concerned, the plane and then the activities out there — a family barbecue at my son's house on Thursday night, a big rehearsal dinner and reception on Friday night (that I have arranged and am paying for so I certainly want to be present), a women's brunch with hair being done at my son's home on Saturday morning and then the wedding on Saturday night. Our plans are to take a red-eye home on Tuesday night, we wanted to do some sightseeing but at this point, I think I may look into changing our flights. Even if we have a penalty it would be somewhat offset by not having the expense of a hotel room.
I think the extent of the injury probably has more to do with my bone density than anything else, although my husband says I went down really hard so it may just be that. I broke a vertebra when I was in my 50s and they immediately thought it must be due to my bones being weak but when they did a density scan they were great but I had not gone through menopause at that time. Another one I went down hard on, on concrete steps. This accident happened, ironically, due to extreme pain in my other leg from sciatica! The pain was so intense that I passed out or probably it was a presyncope episode. Now that leg doesn't hurt at all! I hate not exercising, I feel like my hard work is going down the tubes now. I feel like a slug.

@debbraw Thanks. The doctors have not said much about the pain. The strange thing is that when I went to the ER last Tuesday they kept asking me about my level of pain (1 to 10) and when I was lying on the bed it was negligible but last night it was very bad as it was this morning, even just lying in bed. I hope I haven't done anything to make things worse. They said with this type of fracture since it's not weight-bearing, that I could do whatever I am comfortable with. Right now I am not feeling very comfortable with that and I may try to get in to see the doctor again, or possibly go the Boston to see a different ortho. I would be handling this so much better if not for the timing. I don't dare tell my son that there is some possibility that I may not be able to go, and I don't even want to admit that to myself. I know if I don't go that my husband won't either and he's my son's best man!
JK

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@contentandwell, I hurt for you. I wonder if this is made more difficult for your body because of the transplant medications that you have to take.

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@rosemarya

@contentandwell, I hurt for you. I wonder if this is made more difficult for your body because of the transplant medications that you have to take.

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@rosemarya. Thanks for the concern. I do know that sirolimus tends to cause healing to take longer. They put me back on tacrolimus before my TKR for that reason. I suppose that this healing could take longer also. At least the sirolimus isn’t giving me kidney problems though, so there is a good reason for me to be on it rather than tacrolimus.
JK

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@contentandwell

@merpreb Since there is nothing they do for this type of fracture neither ortho suggested not flying. Maybe they just knew that I’m a determined mother and almost nothing would hold me back.

I am think about returning to the doctor but I don’t who to see. The doctor here in Manchester has excellent credentials but if surgery was necessary I do not want to go into that hospital again. I would be far more comfortable going to Boston but that could take a while to get an appointment, plus I don’t know who I would choose.

A friend brought dinner for us over tonight and there’s definitely enough for a couple of nights so that’s a big help.
JK

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@contentandwell – You could try to get a referral from one of your MGH doctors!

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@merpreb

@contentandwell – You could try to get a referral from one of your MGH doctors!

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@merpreb Thanks, but I checked out the MGH website and there were only two that seemed to fit my needs, and if I do go to Boston I have decided which I would use. It’s feeling a little bit better than it did yesterday so at this point I am doing nothing.

I decided that if I do make another appointment I will go to this guy in Manchester, Dr. Parisien. If it came down to needing surgery I would go to Boston for a second opinion and if that doctor concurred I would have it done there. For now I will just hope it will heal on it’s own.
JK

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@contentandwell

@jeffkirc There are quite a few doctors who use the Conformis knee. If you google Conformis there will be a link to which doctors do it. Since I go to Boston for most of my medical care (I live about 55 miles north in NH), it was an easy choice to use Dr. Fitz since he is one of the developers of the knee. They do scan your knee. I know it is more costly than other knees but it was paid for in full. I really love Dr. Fitz too, he is very caring and diligent, just not “warm and fuzzy”.

Yep, I have a “minimally displaced fracture of the greater trochanter, L femur”, and yes, it really is very painful. I had been so excited and looking forward to my son’s wedding in CO in a few weeks but this has really put a damper on it. I am not looking forward to the flight at all. 🙁

I’m working on not feeling sorry for myself, there are so many worse problems I could have, but it’s interference with a very special week does have me down.
JK

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Have fun at the wedding.Good luck with your pain management. I know they don’t like to prescribe much other than Motrin.
Dr Fitz has a great reputation unfortunately he doesn’t take my insurance. I think I will google “conformis knee” and find the list of MD’s that fo it.

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How does someone really find an excellent surgeon when you have commercial insurance? Sure, there are ways like calling top PT clinics and asking if any particular surgeon has better results than most, but then, you have to check to see if they're in your network. There are websites like Vitals and Health grades but most people comment on office staff, waiting time, and the surgeon's bedside manner. Not the surgery itself. So how do you find the best surgeon? I am 6 months PO and getting a second opinion next week because I am still in agony. I feel something is wrong, my surgeon said my X-rays look great and referred me to pain management Grrrrrr

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The bad news is that no ortho surgeon I know of will see you until you are 1 year post op. I live near Boston – best medical care anywhere – and they all had this policy. I've also had terrible pain for a year, and only had it validated by a great surgeon who I researched to death. The good news is you have time to research. I don't now where you live, but I'd find the closest teaching hospital or ortho-only hospital and start there. Your idea about consulting PTs is also excellent, get a list of name then log on to your insurance company and see if they are in-network.

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@babette Actually, I am being seen by a new OS next week for a new pair of eyes to look at my knee. My current OS works in a teaching hospital so I thought he might be great. Good luck to you and should you get the revision, just think, you will probably feel so much better.

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@dkapustin

How does someone really find an excellent surgeon when you have commercial insurance? Sure, there are ways like calling top PT clinics and asking if any particular surgeon has better results than most, but then, you have to check to see if they're in your network. There are websites like Vitals and Health grades but most people comment on office staff, waiting time, and the surgeon's bedside manner. Not the surgery itself. So how do you find the best surgeon? I am 6 months PO and getting a second opinion next week because I am still in agony. I feel something is wrong, my surgeon said my X-rays look great and referred me to pain management Grrrrrr

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@dkapustin, I think I had an excellent surgeon for my TKR. He also did my Delta Reverse shoulder. It did take about 1 year to be able to get up in the morning and walk across the bedroom without noticing that I had an artificial joint.

When I visited him because of the pain, he took Xrays and then showed them to me and told me that the surgery looked very good. With a gentle hug, he said, "I am so sorry Chris, "it is the facia."

He was absolutely correct. I didn't even know what the word facia meant. He was very helpful. After three years of Myofascial Release Therapy (MFR), I was finally able to start walking again. Not the 5-8 mile walks…the 1-mile walk. Just two weeks ago, I had another "flare". Yesterday, I started to see some daylight. So I don't know if it was something I said that the darn fascia didn't like or ???????. Be free of suffering today….Chris

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